Monthly Archives: May 2011

Here’s a quick recovery exercise for you. Rather than thinking about weeks or months or years ahead of you, each morning set just ONE DAILY INTENTION.

Wake up in the morning and before you do anything, before you get out of bed, before you brush your teeth, think about what your intention for that day is. Just choose one. Think about it, visualize it, see yourself achieving it and hold onto it for the day.

Ideas for daily intentions.

I will eat slowly and mindfully today. I will let myself eat when I’m hungry and stop when I’m satisfied. Just for today.

I will go just for today without binge eating. Just for today.

I will go just for today without purging. Just for today.

I will not compare myself to anyone else today. Just for today.

I will not say mean things to myself today. Just for today.

I will drink 8 glasses of water today. Just for today.

I will refuse to engage in aggressive driving or road rage. Just for today.

I will floss my teeth before bed. Just for today.

Write it on a post it note and post it on your desk at work or your computer, or in your purse or wallet so that you can remember that one intention for the day.

Each day day that you set and stick to an intention will help increase your confidence, self esteem and help you on your road to recovery.

I wondered if you could give me some advice. Sometimes when I feel distressed or tired, I find myself having food fantasies. They are very intense and vivid where I imagine myself eating high-calorie food like cake and other sweet, fatty, high-carb foods. I imagine the taste and the pleasure it would give me. I’m not sure what to do when I have these fantasies because they make me want the food.

To give you some context, I used to be 17kg/37pounds overweight. I recently lost the weight over a period of a year through diet and exercise. However, I have fallen off the wagon and cannot get back on. When I was losing weight, I felt like a new person. I was disciplined, I was extremely fit, I was positive, I had energy and I felt in control.

It’s been six weeks since my fall off the wagon and I can’t get back into that mindset, and now all I can think about is food for comfort. I’ve started to re-gain the weight through comfort eating and no exercise. Sometimes I feel like I don’t know what to eat or how to eat or how to get back to the place where I was exercising regularly, eating healthily and being happy.

Many thanks for your help.

Answer-

Hello and thanks so much for your question.

I have a question for you, if you weren’t thinking about food, what do you think that you would be thinking about?

You very insightfully state that your mind turns to food when you are feeling distressed or tired. This tells me that food is very comforting to you. It’s something that you turn to for comfort and so when you are feeling distressed, you begin to think about food and eating to soothe yourself.

You might want to try using an alternative choice journal. When you find that you are feeling distressed, or your thoughts are drifting toward food, fill this out:

For some ideas on self soothing or self care activities see here and for distractions, check here.

I would encourage you to concentrate on health and well being rather than losing weight. Instead of trying really hard to refocus on losing weight again, think about giving yourself health by exercising in ways that you enjoy. Focus on being emotionally healthy by validating your own feelings and talking to safe people when you’re feeling distressed. Take care of yourself by being gentle and kind to yourself instead of beating yourself up for not being where you think you should be. The irony is, so many people get so angry at themselves when they binge, but the fact that they are bingeing indicates that they need compassion, yet they beat themselves up. If you are bingeing or fantasizing about food, you probably need to give yourself some more attention. Let yourself nap when you are tired and eat when you are hungry. Try to engage in intuitive eating rather than dieting or restrictive eating. Be kind and gentle with you.

A very similar one was asked a few months ago, you might want to check out that answer as well.

Do you have a question about binge eating, bulimia, anorexia, or anything associated with eating disorders? Send an email to bingeeatingtherapy at gmail dot com. All questions will be kept confidential. Include your first name or the name you want to be referred to as and your location.

Hi there, i ran across your website and thought that someone like you might be able to help me through my recovery…

Heres a summary of my case:

I’ve been bulimic for almost 5 years with bingeing and purging routines for about 3-4 times per week (once a day in those days). During the later 2-3 years I’ve added the problem of laxative abuse, starting with a few tablets of Dulcolax and it built up to about 100 tablets a day towards the end of those years. Towards the end i also shifted to this other “herbal laxative”, also taken about 100 or so per day. At the very begining, my weight stood at 130 pounds (almost 60 kilograms, with my height of 160 cm or 5 foot 3 inches). At 130 pounds i decided to start eating healthier and exercise healithily. At that time without the bulimic actions i was able to get my weight down to around 110-115 pounds. Then the bulimia kicked in. Throughout those 5 years my weight got down from 110-115 pounds to a minimum of about 90 pounds, measured about a week ago.

About a week ago, everything changes. I had severe reactions against the laxatives i was using, including nauciousness and just feeling sick all the time. I knew that i had to quit one day, and i knew that my internship had to start soon so i gues it would be a right time to quit. (im 20 years old). So i got on the road of quiting, with full support from my parents, who was well aware of the need to quit. Frankly, i knew that i was going to be tough. I expected and was able to accept a full 10 pounds or so increase in my weight, if that was going to do the quitting.

On the first day, i did a good job of controlling what i ate; i had the help of my mom in guiding me on that. My diet was full of fibers and proteins with some carbs. I also did some exerising about 30 minutes a day for the past week. Prior to this, i knew that fluid retention wil result, but i definitely underestimated its affects on my weight. The routine i did on the first day of quitting continuted for 3 days. After 3 days, I was super constipated since i was not able to “go to the bathroom” like that…on my own. On the third day my weight increased from around 90 to 96 pounds…i was quite shocked and felt very bloated. I purged on the end of the third day because i felt sooo constipated and bloated, but very little, compared to what i was doing for the past 5 years. On day 4 and day 5, things went on the same way, i stil had trouble going to the bathroom and took a few tablets of laxative to help my body a litle bit.

So right now im standing on day 6-7 of the recovery. my weight now is about 98-99 pounds. my goal is to quit but keep my weight to be around 100 pounds or so. im really dreading this road of quitting and im really worried that my weight will go on increasing nonstop especially with the fluid retention. i drink so much fluid this past week and i dont pee it out much at all, i feel like al the fluid i intake is converted in to weightweight and addds on to my number on the scale and never gets rejected out anymore. So in short the past week was a semi recovery as in i dont rely on constant puking and constant laxative taking anymore but i did cheat and do one or two of each just to keep my weight from exploding. And yes i realize that this is not good since i plan to completely quit. there stands my issue.

I was wondering if you have any advice as to how to better approach this road. Keep i mind that i DONT want to gain more weight than around 100-102 pounds =[ and is there anyway to trigger my system to function normally as soon as possible? i mean tons of fruits and vegies that i have been eating havent helped at all in my digestive system and the “going to the bathroom” stuff.

I do very much appreciate your time and effort to help

Answer:

Disclaimer: I am not a doctor and this advice is not intended to treat any condition nor is it a substitute for medical care.

It’s so great that you have chosen to seek help. That’s very brave of you. It’s so difficult to come forward and look for help. I’m really so happy that you reached out.

First off, please, please, please get yourself to a medical doctor immediately.

You are in a very, very precarious position right now. There is so much going on in your body and you are quite ill with an extremely serious eating disorder. You need more than just your parents helping you. You need to be monitored by a whole medical team as well as a psychologist or psychotherapist who specializes in Eating Disorders. To find treatment go here.

It seems that your weight is very low. If haven’t menstruated for at least 3 months, you would be considered anorexic. Your desire to stay at such a low weight is dangerous. With your low weight, the fact that you are exercising daily, the use of laxatives and bingeing and purging you are at increased risk for cardiac arrest and organ failure. Your whole system is at risk.

When people stop purging and using laxatives, they usually suffer from severe water retention and their digestion takes a while to normalize. This is because your body has been losing water so rapidly for so many years. The moment it receives food, it will do whatever it can to hold onto. It’s been starving for nutrients. As you allow yourself to eat normally, your bodily functions will take over.

You want to recover from your eating disorder, yet you want to stay 100 pounds. Unfortunately, it’s not possible to do both as your weight is too low for your height, so staying at that weight would inherently keep you in an eating disorder.

You want to know how to trigger your system to function normally as soon as possible. However, you have been abusing your body for 5 years. It will take awhile for your system to heal or recover.

I’m sorry that I can’t give you the answers that you want, but I’m afraid that your eating disorder voice is asking these questions. You are trying to figure out how to stay underweight without bingeing and purging and using laxatives and you are trying to figure out a quick way to normalize your digestion without working with a doctor and nutritionist. Unfortunately, this will take time. However, if you choose to get into treatment, your quality of life will hopefully improve.

I know that you have an internship coming up and it’s hard to balance recovery and work, school, etc. Many people decide to take some time off from school or work to focus directly on recovery. It can be helpful as often it’s very hard to do school when the eating disorder is so pervasive. It’s also hard to do recovery when you have no time to focus on yourself.

Thanks again so much for reaching out. I am rooting for you and I hope that you get the help and recovery that you need.

Do you have a question about binge eating, bulimia, anorexia, or anything associated with eating disorders? Send an email to bingeeatingtherapy at gmail dot com. All questions will be kept confidential. Include your first name or the name you want to be referred to as and your location.

Isolation and eating disorders go together for many reasons. Often people find themselves avoiding situations where food will be involved because they are either afraid of overeating or they don’t want deal with the questions or the looks if they are restricting. People also find that they begin pushing away friends, family, and partners in order to spend more time with their ED behaviors. Some women or men prefer to spend the night alone or away from their boyfriend or girlfriend in order to spend the night bingeing. Some will prioritize gym time at the expense of loved ones. Many bow out of social obligations because they are not comfortable with their bodies and are afraid that they will be judged.

Reaching out is a huge part of recovery. This doesn’t necessarily mean going to an eating disorder recovery group or a support group or 12 step group, although these things can be very important for recovery. This can be as simple as reaching out to friends, parents, family members or even people who you don’t know very well, who you can just be social with. Being out in the world rather than being alone with your disorder is one of the great ways to find recovery. Connection with people – even when you feel imperfect, even when you’d rather be at home bingeing or running on the treadmill or avoiding food and people- can help you heal. We are interdependent beings. You don’t even have to talk about your feelings or what you’re going through, just being with people who you enjoy, just having contact with others and getting out of the isolation trap is a giant step toward freedom from your addiction.

Next time you have the urge to isolate, try to reach out and spend some time with a friend, or a family member, or even a neighbor or someone you don’t know very well. You can even do volunteer work at a soup kitchen or homeless shelter, or a community garden. Anything that gets you out and close to other humans can be healing.

Shame for eating too much, shame for eating too little, shame for the way you look, shame for the body you’re in, shame for the things you do, for the thoughts that you have, shame for lying about what you ate, shame for eating out of the garbage can, shame for stealing food, shame for drinking too much, shame for taking risks, shame for flirting, for being rejected, shame for not being good enough, shame for being too good, shame for being too proud, shame for your size, shame for your shape, shame for your job, shame for how much or how little money you make, shame for where or where you didn’t go to school, shame for your parents, your husband, your wife, your friends, the people you associate with, your home, your judgements, your fears, your sleep patterns, your sex acts or masturbation habits, your messiness, your car, your furniture, do you ever feel shame simply because of who you are?

Renowned shame researcher Brene’ Brown defines shame as “the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging.” Because we are human, we want to feel loved for who we are, not for what we do or how we look, yet, somehow, at some point, many of us lose that sense, that we should be loved unconditionally and spend the rest of our lives trying to deem ourselves worthy of love. And for many, the task seems so momentous, that they give up. They believe that they are not worthy of love and figure “why try?” Well the good news is, you are worthy of love whether you try or not. You are worthy of love if you’re fat or if your skinny, if you’re binge eating or if you’re purging or if you’re using drugs or drinking, or having sex with the wrong people, you’re still worthy of love. You don’t have to do anything to be valuable as a human being.

Yet, so many of us don’t believe that. Shame is a huge contributor to binge eating disorder. We believe that we are so damaged and so broken that we have to fix ourselves. One of the ways that people try to fix themselves is by losing weight and becoming thin, they believe that if they are thin, they will be impervious to criticism by self and others. However, dieting can become binge eating, which then creates shame, which creates diet, which creates bingeing which creates shame.

Shame + Diet = Binge = Shame. People diet to get rid of shame. It’s almost as though they believe that they can sweat it away or starve it away.

But you can’t get rid of shame by trying to fix yourself.

Fixing yourself because you believe you are broken is very different than self growth and evolution and working to become healthy because you love yourself. Fixing yourself because you are broken is a task of Sisyphean proportions because you will never be fixed. Mostly because you were never broken. You just thought you were, and you will continue to think you are until you find the antidote to shame, which is acceptance.

Because you believe that you are broken, there’s a part of you who tries to destroy yourself. How many times have you seen people reinvent themselves, “that was the old me, this is the new me!” (Ala Kirstie Alley– over and over and over again).

You’re always you. It’s okay, it’s necessary even to improve and change, but that happens naturally through the course of life experience, self growth, holding integrity and finding yourself. One of the wonderful parts about finding yourself is when you stop trying to fit into a mold that you think you’re supposed to be, you find that the person underneath is truly wonderful. Maybe the things that you do are not wonderful. Maybe the habits that you have are bad, or even shameful. But who you are and what you do are not one in the same. As you begin to accept who you are, you stop trying to destroy that person with bingeing, starvation, purging, excessive dieting, compulsive exercise, abusive self talk, promiscuity, or other self harming behaviors that have the underlying intention of making you more acceptable.

So how do you accept yourself and find some freedom from shame? That’s not a simple question.

One of the ways is through radical acceptance. Not necessarily liking the things to do, the habits you have, the things you say, the mistakes you make, the feelings you have, but accepting them without judgment.

Dr. Brene Brown talks about healing shame through connection and empathy. Having the courage to share your stories, your mistakes, places where you messed up with someone who will listen and empathize, and also being able to hear others’ stories with empathy and without judgement or criticism. A great place for this is group therapy or 12 step groups.

Having integrity. Thinking about what traits you respect in other people and applying them to yourself. Traits aren’t eating carrot sticks instead of pizza. Those are habits. Traits are kindness, compassion, consideration. Think about who you would want to have as a best friend and be that person to yourself. So often I see people come in who have best friends who they consider to be bitches. They hate their best friends. Yet somehow, they keep them around because they want to be like them, “she’s pretty, thin, rich, popular…” etc. They aspire to be like that person, yet they don’t really like that person. Be your own best friend and be the friend to others that you would want for yourself. Holding yourself with integrity helps you to feel good about who you are.

Break the binge-shame-binge cycle. Don’t beat yourself up. When you catch yourself beating yourself up, be kind. You are not a bad person because you binged. You binged because you thought that you were a bad person. The irony is, when you have a binge, that’s when you need the most compassion because you were probably having a tough time to begin with. So be kind to yourself.

Do you ever look at people and think that their lives are so much better than yours? Do you ever wish that you had someone else’s body, their boyfriend/girlfriend, their apartment, their job, their money, their clothes? Do you ever look at someone then hate yourself?

If so, you’ve experienced the kind of jealousy and envy that causes despair.

Some people have the habit of comparing their lives to the lives of someone else and then feeling bad about themselves. Compare and Despair. Or, as one of my former supervisors referred to it, “compare and destroy.” The truth is, when you compare yourself to other people, you can often wind up obliterating yourself or destroying the other person in your head. For instance, “She’s very pretty– therefore I must be ugly, I hate myself…” or “She’s very pretty… but she’s stupid and she dresses badly.” Rather than having someone’s positive attributes have nothing to do with you at all. Just because someone is smart doesn’t mean you’re not smart enough. Just because someone is beautiful doesn’t mean you’re not. Just because someone is successful doesn’t mean that you can’t be.

Jealousy, broken down into its core components is anger at someone for having something that you don’t because on some very primal level, you believe that they are stealing something from you. If they have it, you can’t have it.

People often measure themselves against others as a way of understanding where they fall, how they’re doing. We don’t get graded in life. So, perhaps if we can see who has the most money, the thinnest legs, the biggest house, the handsomest husband, we can understand where we stand.

This can be particularly true with body image. Many women spend a great deal of their day and their mind space comparing their bodies to the bodies of other women and then feeling badly about themselves. This kind of comparison is so detrimental to your mental and emotional health. It pulls you away from you. You become so busy looking at what other people have that you begin to forget about yourself. This isn’t only true about comparing yourself to a body that you think is “better” than yours, it’s also when you compare yourself to a body that you think is “worse” than yours. There are no qualitative parameters on bodies. You have been given one and it’s up to you to care for it alone. Each person has their own dharma and their own path. It’s up to you to travel along on your own path, to go forward and figure out all your obstacles and roadblocks. When you compare yourself to others, you begin to look to other people’s paths. In doing that, you stop moving forward on your own. You can’t jump on anyone else’s path. You have your own. Each person has their own life and their own problems. When you compare yourself and your life to other people’s, you’re not taking into consideration that you don’t actually know what’s going on in their lives. You’re comparing yourself to a fantasy that you are having about someone else’s life.

First, notice if you are trying to destroy them in your head. Stop doing that. It’s not productive and it doesn’t feel good in your body, nor does it help you get closer to your goal.

Then, what is it that you’re jealous of? Is this something that you can have? If so, how can you get this thing. If not, think about how your life differs, and what makes you and your life unique and how you can continue on your own life.

Empower yourself by thinking about what in your life you can control and making moves to go there. Jealousy is totally unempowering. It makes you feel helpless and paralyzed. People try to empower themselves and make themselves feel better with idle gossip. Trying to elevate yourself by devaluing someone else is never a good idea. It keeps you small. Elevating yourself by being a genuinely good person and working to reach your goals will help you to deal with your jealousy. You will remember that you have your own life and your own personal goals that you are working toward that have nothing to do with anyone else’s goals or path.

As you move through your life, and pay attention to your own life, give your life and your self attention. When you obsess and dwell on what others have, you avoid yourself, you reject yourself and your life. It’s not conducive to positive change or a happy life.

Pay attention and give love to you and you will reap those rewards and begin to enjoy what you do have.

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This is a blog to promote the awareness of eating disorders and to receive some help and support for healing from binge eating and bulimia. A good place to start is here!

Send me any questions you might have about eating disorders, recovery, therapy, binge eating or compulsive eating, body image issues, bulimia, or anything else that falls into that category. I will do my best to answer on Q&A Fridays. Email all questions to:
bingeeatingtherapy (at) gmail (dot) com.
If you live in San Francisco and are looking for Psychotherapy for help with food and body image issues, please don't hesitate to contact me at: 415-820-1478
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